In addition to gaining DR skills in imaging and image-guided procedures, the practice of IR requires a specific emphasis on nonprocedural patient care. This distinguishing feature of IR consists of physician activities such as conducting physical examinations, obtaining patient history separate from the performance of procedure, independently formulating a plan of evaluation and treatment, performing of treatment, and providing follow-up care. As such, the training paradigm for IR is shifting. Below are some of the frequently asked questions (FAQs) regarding the evolving training for IR.
What is the difference between the “VIR Track” and “Clinical Pathway”?
- They are the same thing. The “Clinical Pathway” is the official name and the VIR-Track is the popular name.
What is the DIRECT Pathway?
- This is a pathway combining surgery (first two years) and radiology residency with a focus on image-guided and minimally invasive surgeries and procedures. It is different from the VIR Clinical Pathway and is no longer supported by the ABR with the advent of the IR Residency.
Does U of M Have a DIRECT Pathway and are we recruiting?
- No we are not recruiting for the DIRECT Pathway
What is the IR Residency and when will it be implemented?
- The IR Residency (also known as the IR-DR pathway or dual certificate program) is basically just like the 1-internship + 3-DR + 1-focus year plus an additional IR focused residency year for a total of 6 years. Graduates will be able to become ABR certified in both diagnostic radiology and in interventional radiology.
- The ACMGE has approved the program requirements for the IR Residency with pending approval of programs.
Is the current one-year IR fellowship going to go away?
- Yes. It is expected that the current internship/residency/fellowship (1-4-1) will be replaced by the 6 year IR Residency. The IR fellowship will no longer exist starting June 30th, 2020.
Is a surgical internship required for the VIR Clinical Pathway and/or for the future IR residency?
- A surgical internship is strongly encouraged for either program, and will make candidates more competitive for their advanced IR training, but it is not required, at this time.
What is the difference between the current VIR Clinical Pathway and the future IR residency?
- The VIR Clinical Pathway is like any focused diagnostic radiology residency which consists of a 5 year residency (1 yr. intership+3 yrs. DR+1 yr. focus in IR) plus an additional 1-year fellowship in IR. The IR Residency is a 6-year residency (1+3+2) after which there is no separate fellowship.
- The PGY-6 year of the VIR Clinical Pathway is called a fellowship, while the PGY-6 year of the IR Residency is the last year of residency.
- The curricula are similar for both programs. In the VIR Clinical Pathway, residents are eligible for a DR primary certificate from the ABR with CAQ in IR (likely to be converted to IR primary certificate). In the IR Residency, residents will be eligible for a primary certificate in both DR and IR.
Is the curriculum the same or different for the VIR Clinical Pathway versus the IR residency?
- Our curriculum is essentially the same as the guidelines approved by the ACGME.
If a medical student signs up and matches into the VIR Clinical Pathway before the IR residency is launched, can they be “grandfathered” into the IR residency later?
- This is a probable scenario based on the ACGME program requirements.
- Efforts are underway to synchronize the requirements so that a resident can move from the VIR Clinical Pathway that they matched into as part of the Diagnostic Radiology Residency Program into the IR Residency program, assuming they have complied with the program requirements during that time. This should be possible since the first 5 years of both the VIR Clinical Pathway and the IR Residency program are essentially the same. This will require approval by the program directors of the DR residency and the IR Residency, the GME office, and the ACGME Radiology RRC, which is likely to occur.
If a student matches into the Diagnostic Radiology Residency and not into the VIR Clinical Pathway, can they “crossover” into the VIR Clinical Pathway and/or the IR Residency later? And how late can we do so?
- Potentially. The program directors of both the DR residency and the IR Residency must approve this change. To move from the DR residency into the IR Residency also requires the approval of the GME office and the ACGME Radiology RRC. Candidates will be evaluated in the same manner as applicants for future IR Residency program.
- Remedial rotations and reconciliation of rotations may be necessary in order to meet all the program requirements.
- If you find yourself considering this, the earlier the better.
Is there going to be a difference in the training of the VIR Clinical Pathway residents and Diagnostic Radiology residents in the first three years of radiology residency?
- No, there should be no considerable difference in the program requirements and rotations. During IR rotations, residents with higher skill sets will probably advance more quickly to more complex procedures than others.
- Yes there are 3 additional clinical rotations that diagnostic radiology residents will not do. These clinical rotations include: Vascular Surgery (2 months), SICU (1 month)
Do the VIR Clinical Pathway residents take the same call as Diagnostic Radiology (non-IR Clinical Pathway) residents?
- Both sets of residents are expected to take the same quality (type) and quantity of call during the 3 years of DR (years 2, 3, and 4 of the program).
- In addition, the VIR Clinical Pathway residents may take additional call during part or all of the focused IR rotations of residency (PGY-5). This may be q-5 to q-6 call.